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how open can i be before being hospitalized? - October 21st 2017, 07:09 PM

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not sure if this is the right forum; if not i apologize!
so within the past few weeks, i started attending free therapy sessions with my college's psychologist. i'm familiar with how therapy works - i was in and out of various therapists offices for years when i was younger. so far, i've actually clicked with this counselor better than anyone else i've tried. financial difficulties and previous, really awful experiences are currently preventing me from seeing a psychiatrist along with this counselor.
one thing that i noticed was different, though, is that i never had to fill out any kind of paperwork, and there was never really a discussion of confidentiality. i know the drill - it's all private unless you pose a threat to yourself or others. but still, she never really brought it up.
i've been doing okay for the past few days, but generally speaking, i'm very, very suicidal on the daily. i'll endure multiple intense crying episodes throughout the day and spend a great deal of time contemplating exactly how and when i would kill myself. when i'm not directly suicidal, i'm contemplating ways to harm myself enough to end up in the hospital. i also do various things to cause pain or harm to myself.
this is something i really feel i should be discussing with her, obviously, but i'm not sure to what extent i can discuss these things without her requiring i undergo hospitalization.
if i'm being honest, i probably do need to go to the hospital. but my family absolutely cannot afford it and my father would use it as an excuse to lash out on me more than he already does.
how much of this can i tell her about, without being made to go to the hospital? should i just not bring up the suicidal/self-destructive urges at all?
any insight is greatly appreciated. thank you.
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Re: how open can i be before being hospitalized? - October 24th 2017, 09:30 PM

Glad to hear that you get on well with your counsellor!

It's definitely a good idea to talk to your counsellor about the self destructive urges and suicidal thoughts. It's difficult to say where the limit is between keeping the disclosure confidential and breaking the confidentiality for your safety. I would say that having the suicidal thoughts but not acting on them (e.g. not researching methods, writing goodbye notes, attempting suicide) might make you less likely to be hospitalised. But it also depends on your counsellor, since some counsellors will ask and talk about potentially being hospitalised with their clients before breaking confidentiality (but not always).

You can always ask your counsellor about what kind of things she would specifically have to take action on, and you could always talk about the problems associated with being hospitalised (it's definitely not right that your father would use it as an excuse to lash out). It could give you a chance to explore other options so that you are able to get the help you need, rather than feeling like you have to go without.

Sorry for the late reply, but hope this is somewhat helpful!

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Re: how open can i be before being hospitalized? - October 25th 2017, 02:07 AM

thank you :^)
i met with her this morning. i tried to be as honest as i could while still treading lightly, which means i kind of sugar-coated things a bit. i told her i think of dying a lot and instead of telling her i actively harm myself, i implied that i just act recklessly without caring for my safety. i wish i could be more upfront, of course, but i really cannot go to the hospital under my current circumstances.
in the future i guess i'll just have to err on the side of caution with these things. i'm going to ask her, a couple sessions from today's, if she could specify what would necessitate immediate intervention on her end.
thank you for your help! xx
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Re: how open can i be before being hospitalized? - October 25th 2017, 04:41 AM

I have always been able to be pretty open with my therapists regarding my self harm. Even when they knew I was doing quite severe damage, they didn't outright seek out hospitalization. I think that was because the doctors I worked with didn't think that hospitalization would help in regards to my self harm.

The only time I have ever had a therapist hospitalize me was when I was open about the fact that I was thinking about suicide and I had a plan.

However, these rules are very subjective because it's all about your therapist and if they view you as a threat to yourself or others. It is possible that there might be a therapist out there who will look at the fact that you self harm and think you need to be hospitalized.

One way I was able to, initially, talk to people about myself harm was by saying that it wasn't something I did often. By doing this, I was able to see how the therapist would respond. If they overreacted in any way I would know they probably were not the doctor to open up to about my self harm and I would look for another one. If they handled it well, I would eventually work in to telling them that I self harmed a bit more regularly. With one of my therapists, they would check in each session to see if I had self harmed and I was able to be honest and that felt nice.

Here's the thing, I know your family cannot afford for you to be hospitalized but your well-being is so important. If you are able to get help by going to therapy alone, that is great, however, if you notice that you are getting worse and you are going to harm yourself please seek help. Your life is so important and getting more extensive help can sometimes be what a person needs to see improvement.

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Re: how open can i be before being hospitalized? - October 25th 2017, 02:15 PM

thank you! trying to get a feel for her reaction is a good idea.
even I can admit to myself that I most likely do need to go to the hospital, and I do understand that I need to protect my own life, first and foremost. I've been seriously considering it for a while now, despite the limitations. thank you for your concern and help!
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